Affidavit of Indigency or Economic Status Sample

Affidavit of Indigency or Economic Status Sample

Affidavit is a document executed by an individual who appears before the notary to subscribe the same.

The process of executing an affidavit refers to an act in which an individual, on a single occasion: (a) appears in person before the notary public and presents an instrument or document; (b) is personally known to the notary public or identified by the notary public through competent evidence of identity as defined by these Rules; (c) signs the instrument or document in the presence of the notary; and (d) takes an oath or affirmation before the notary public as to such instrument or document.

An Affidavit of Indigency is required in several situations one of which is to prove that the individual does not have the means to pursue an activity and needs the help of the government. In certain instances, this is required prior to the grant of the government benefit.

Below is the sample affidavit of indigency or economic status:

Republic of the Philippines )
City of Makati                        ) S.S.


I, JUAN DELA CRUZ, Filipino, of legal age, and a resident of 1234 Kurimaw St., Brgy. Tetanus, Makati City, after having been duly sworn to, in accordance with law, do hereby depose and state that:

  1. I was working as a Waiter in a restaurant when the lockdown happened due to enhanced community quarantine (ECQ);
  2. After the ECQ, I already lost my job;
  3. I am executing this document for submission with Brgy. Tetanus for issuance of the Certificate of Indigency to seek financial support for my status, and to attest to the truth of the foregoing statements.



ID: _________________________


SUBSCRIBED AND SWORN to, this 4th day of January 20_____, the affiant personally appeared and presented to me her competent evidence of identity shown above.



Doc. No.: __________;
Page No.: __________;
Book No.: __________;
Series of 20___.

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